title: Patterns of care for cervical cancer in Auckland, New Zealand, 2003-2007.
abstract: BACKGROUND
  The purpose of this review is to document current patterns of care for the International Federation of Gynecology and Obstetrics (FIGO) stage IB1 to IVA cervical cancer in a New Zealand cancer centre.
  
  
  METHODS
  This is a retrospective review of women with newly diagnosed FIGO Stage IB1-IVA cervical cancer in the Auckland/Northland regions between 2003 and 2007.
  
  
  RESULTS
  Two hundred seven patients were identified. Fifty-three percent were stage IB, 24% stage II, 19% stage III and 3% stage IVA. Factors associated with stage ≥ IIB were age >50, lack of participation in cervical screening and public first specialist assessment. Ninety percent (90/100) of stage IB1 patients and 73% (8/11) of stage IB2 patients were treated with primary surgery. Thirty-eight percent of surgically treated stage IB1 and 100% of surgically treated stage IB2 tumours had indications for adjuvant radiotherapy. Radiotherapy utilisation rates were: stage IB 49% (IB1 44%, IB2 91%); stage II 93%; stage III 90%; and stage IVA 71%. Brachytherapy utilisation rate (BTU) for stages IIB to IVA was 64% overall and 75% in definitively treated patients. Seventy-five percent of patients treated with definitive radiotherapy received concurrent cisplatin chemotherapy.
  
  
  CONCLUSIONS
  Both radiotherapy and brachytherapy utilization rates were below optimal and are being addressed. No formal surgical or chemotherapy utilisation estimates exist for comparison; however, the use of concurrent cisplatin chemotherapy was similar to other groups. A high rate of adjuvant (chemo)radiotherapy was noted in surgically treated Stage IB patients, suggesting a need for an increased consideration of primary chemoradiotherapy in these patients to avoid the unnecessary toxicity of trimodality therapy. Future outcome analysis is planned.
authors.affiliation: Department of Radiation Oncology, University of Auckland, Auckland, New Zealand. lisa.capelle@albertahealthservices.ca
authors.forename: Lisa
authors.initials: L
authors.lastname: Capelle
authors.forename: Wendy
authors.initials: W
authors.lastname: Stevens
authors.forename: Susan
authors.initials: S
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000628:therapy*; D055815:Young Adult